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男性癌症患者接受 IVF/ICSI 周期的结果:2004 年至 2018 年回顾性分析程序。

The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018.

机构信息

Department of Human Reproduction, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Radiol Oncol. 2021 Mar 5;55(2):221-228. doi: 10.2478/raon-2021-0011.

Abstract

INTRODUCTION

Fertility preservation is an important aspect of quality of life in oncological patients, and in men is achieved by semen cryopreservation prior to treatment. Results of fertilization (IVF) procedures in healthy infertile couples are comparable, regardless of whether fresh or cryopreserved semen is used, but are scarce in male oncological patients.

PATIENTS AND METHODS

We performed a retrospective analysis of IVF/intracytoplasmic sperm injection (IVF/ICSI) procedures in infertile couples where men had been treated for cancer in the past. We additionally compared the results of IVF/ICSI procedures with respect to the type of semen used (fresh, cryopreserved).

RESULTS

We compared the success rates of 214 IVF/ICSI cycles performed in the years 2004-2018. Pregnancy (30.0% . 21.4%; p = 0.12) and live-birth rates (22.3% . 17.9%; p = 0.43) per oocyte aspiration were similar between the groups in fresh cycles; however embryo utilization (48.9% . 40.0%; p = 0.006) and embryo cryopreservation rates (17.3% . 12.7%; p = 0.048) were significantly higher in the cryopreserved semen group. The cumulative pregnancy rate (60.6% . 37.7%; p = 0.012) was significantly higher, and the live-birth rate (45.1% . 34.0%; p = 0.21) non-significantly higher, in the cryopreserved semen group.

CONCLUSIONS

The success of IVF/ICSI procedures in couples where the male partner was treated for cancer in the past are the same in terms of pregnancies and live-births in fresh cycles regardless of the type of semen used. However, embryo utilization and embryo cryopreservation rates are significantly higher when cryopreserved semen is used, leading to a significantly higher cumulative number of couples who achieved at least one pregnancy.

摘要

简介

在肿瘤患者中,生育力保存是生活质量的一个重要方面,可以通过在治疗前对精子进行冷冻保存来实现。在健康的不孕夫妇中,无论使用新鲜还是冷冻的精子进行受精(IVF)程序,其结果都是可比的,但在男性肿瘤患者中却很少见。

患者和方法

我们对过去曾接受癌症治疗的不孕夫妇的 IVF/胞浆内单精子注射(IVF/ICSI)程序进行了回顾性分析。我们还比较了不同精液使用类型(新鲜、冷冻)对 IVF/ICSI 程序结果的影响。

结果

我们比较了 2004 年至 2018 年期间进行的 214 个 IVF/ICSI 周期的成功率。新鲜周期中,每个卵母细胞抽吸的妊娠率(30.0%. 21.4%;p = 0.12)和活产率(22.3%. 17.9%;p = 0.43)相似;然而,在冷冻精液组中,胚胎利用率(48.9%. 40.0%;p = 0.006)和胚胎冷冻保存率(17.3%. 12.7%;p = 0.048)显著更高。冷冻精液组的累积妊娠率(60.6%. 37.7%;p = 0.012)显著更高,活产率(45.1%. 34.0%;p = 0.21)虽非显著更高。

结论

在过去曾接受癌症治疗的男性伴侣的夫妇中,新鲜周期中无论使用哪种精液类型,IVF/ICSI 程序的成功率在妊娠和活产方面是相同的。然而,使用冷冻精液时,胚胎利用率和胚胎冷冻保存率显著更高,导致至少有一次妊娠的夫妇数量显著增加。

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